Tuesday, December 06, 2011

Dr. Rubi Li vs. Spouses Reynaldo and Lina Soliman as parents/heirs of deceased Angelica Soliman, G.R. No. 165279. June 7, 2011

Medical malpractice. An integral part of physician’s overall obligation to patient is the duty of reasonable disclosure of available choices with respect to proposed therapy and of dangers inherently and potentially involved in each. However, the physician is not obliged to discuss relatively minor risks inherent in common procedures when it is common knowledge that such risks inherent in procedure of very low incidence. Cited as exceptions to the rule that the patient should not be denied the opportunity to weigh the risks of surgery or treatment are emergency cases where it is evident he cannot evaluate data, and where the patient is a child or incompetent. The court thus concluded that the patient’s right of self-decision can only be effectively exercised if the patient possesses adequate information to enable him in making an intelligent choice. The scope of the physician’s communications to the patient, then must be measured by the patient’s need, and that need is whatever information is material to the decision. The test therefore for determining whether a potential peril must be divulged is its materiality to the patient’s decision. 

Cobbs v. Grant reiterated the pronouncement in Canterbury v. Spence that for liability of the physician for failure to inform patient, there must be causal relationship between physician’s failure to inform and the injury to patient and such connection arises only if it is established that, had revelation been made, consent to treatment would not have been given. 

There are four essential elements a plaintiff must prove in a malpractice action based upon the doctrine of informed consent: “(1) the physician had a duty to disclose material risks; (2) he failed to disclose or inadequately disclosed those risks; (3) as a direct and proximate result of the failure to disclose, the patient consented to treatment she otherwise would not have consented to; and (4) plaintiff was injured by the proposed treatment.” The gravamen in an informed consent case requires the plaintiff to “point to significant undisclosed information relating to the treatment which would have altered her decision to undergo it. 

The element of ethical duty to disclose material risks in the proposed medical treatment cannot thus be reduced to one simplistic formula applicable in all instances. Further, in a medical malpractice action based on lack of informed consent, “the plaintiff must prove both the duty and the breach of that duty through expert testimony. Dr. Rubi Li vs. Spouses Reynaldo and Lina Soliman as parents/heirs of deceased Angelica Soliman, G.R. No. 165279. June 7, 2011

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